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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Enteral and parenteral nutrition in cancer patients, a comparison of complication rates: an updated systematic review and (cumulative) meta-analysis
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Enteral and parenteral nutrition in cancer patients, a comparison of complication rates: an updated systematic review and (cumulative) meta-analysis

机译：肠内和肠外营养在癌症患者中，并发症率的比较：更新的系统审查和（累积）META分析

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Introduction Weight loss in cancer patients is a worrisome constitutional change predicting disease progression and shortened survival time. A logical approach to counter some of the weight loss is to provide nutritional support, administered through enteral nutrition (EN) or parenteral nutrition (PN). The aim of this paper was to update the original systematic review and meta-analysis previously published by Chow et al., while also assessing publication quality and effect of randomized controlled trials (RCTs) on the meta-conclusion over time. Methods A literature search was carried out; screening was conducted for RCTs published in January 2015 up until December 2018. The primary endpoints were the percentage of patients achieving no infection and no nutrition support complications. Secondary endpoints included proportion of patients achieving no major complications and no mortality. Review Manager (RevMan 5.3) by Cochrane IMS and Comprehensive Meta-Analysis (version 3) by Biostat were used for meta-analyses of endpoints and assessment of publication quality. Results An additional seven studies were identified since our prior publication, leading to 43 papers included in our review. The results echo those previously published; EN and PN are equivalent in all endpoints except for infection. Subgroup analyses of studies only containing adults indicate identical risks across all endpoints. Cumulative meta-analysis suggests that meta-conclusions have remained the same since the beginning of publication time for all endpoints except for the endpoint of infection, which changed from not favoring to favoring EN after studies published in 1997. There was low risk of bias, as determined by assessment tool and visual inspection of funnel plots. Conclusions The results support the current European Society of Clinical Nutrition and Metabolism guidelines recommending enteral over parenteral nutrition, when oral nutrition is inadequate, in adult patients. Further studies comparing EN and PN for these critical endpoints appear unnecessary, given the lack of change in meta-conclusion and low publication bias over the past decades.
机译：引言癌症患者的减肥是一种令人担忧的构成变化，预测疾病进展和缩短生存时间。抵抗一些减肥的逻辑方法是通过肠内营养（EN）或肠胃外营养（PN）给药营养支持。本文的目的是更新以前由Chow等人发布的原始系统审查和荟萃分析，同时还评估随机对照试验（RCT）随着时间的推移对元结论的出版质量和影响。方法进行文献搜索;筛查于2015年1月发表的RCT进行筛选，直到2018年12月。主要终点是患者无感染的患者的百分比，无营养支持并发症。次要终点包括患者的比例，达到没有重症并发症和没有死亡率。审查经理（Revman 5.3）通过Cochrane IMS和Biostat的全面的Meta-Analysis（版本3）用于终点分析和出版质量评估。结果自我们的先前出版以来，确定了七项研究，导致我们的审核中包含了43份文件。结果回应了先前发表的那些; EN和PN在除感染外的所有端点中是等同的。亚组仅含有成人的研究分析表明所有终点中的风险相同。累积的Meta分析表明，由于除了感染终点外的所有终点之外的出版时间开始，所以结论仍然是相同的，这在1997年出版后的研究后变化。偏差风险很低，通过评估工具和漏斗情节的视觉检查确定。结论结果支持当前欧洲营养和代谢指南推荐肠内营养的准则，当时口腔营养不足，成人患者。在过去几十年中，考虑到缺乏Meta结论和低出版物偏见的变化，因此不需要对这些关键终点进行比较的进一步研究。

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